Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.

fig2: Plasma epinephrine, norepinephrine, and blood glucose level of patients receiving intranasal DEX and placebo before operation and after operation. Values are given as mean ± SEM. Between-group comparison of epinephrine, norepinephrine, and blood glucose after operation. DEX group was lower than that of Placebo group (P = 0.0063, P < 0.0001, and P < 0.0001, resp.).

Mentions:
Plasma concentrations of epinephrine, norepinephrine, and blood glucose before operation and after operation are displayed in Figure 2. All were with no difference between the groups before operation and they all increased in both groups after operation compared to before operation, but the difference of the three variables was significant in Placebo group in contrast with only the blood glucose in DEX group (P < 0.0001). Between-group comparison of epinephrine, norepinephrine, and blood glucose after operation and DEX group was lower than that of Placebo group (at P = 0.0063, P < 0.0001, and P < 0.0001, resp.).

fig2: Plasma epinephrine, norepinephrine, and blood glucose level of patients receiving intranasal DEX and placebo before operation and after operation. Values are given as mean ± SEM. Between-group comparison of epinephrine, norepinephrine, and blood glucose after operation. DEX group was lower than that of Placebo group (P = 0.0063, P < 0.0001, and P < 0.0001, resp.).

Mentions:
Plasma concentrations of epinephrine, norepinephrine, and blood glucose before operation and after operation are displayed in Figure 2. All were with no difference between the groups before operation and they all increased in both groups after operation compared to before operation, but the difference of the three variables was significant in Placebo group in contrast with only the blood glucose in DEX group (P < 0.0001). Between-group comparison of epinephrine, norepinephrine, and blood glucose after operation and DEX group was lower than that of Placebo group (at P = 0.0063, P < 0.0001, and P < 0.0001, resp.).

Bottom Line:
Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05).The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001).Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.